Individual
STEPHEN MAURICE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3391 NW PANORAMA DR, BEND, OR 97701-5461
(541) 693-4376
Mailing address
3391 NW PANORAMA DR, BEND, OR 97701-5461
(541) 693-4376
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD21866
OR
Other
Enumeration date
02/25/2015
Last updated
02/25/2015
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